P6580Prevalence and clinical significance of latent Brugada syndrome in juvenile lone atrial fibrillation

Abstract Introduction Brugada syndrome (BrS) cause about 20% of sudden cardiac death (SCD) in young healthy adults. Nearly 20% of Brugada patients develop supraventricular arrhythmias, mostly atrial fibrillation (AF). But whether lone AF may be the first clinical manifestation in young patients with latent BrS remains unclear. Purpose To estimate the prevalence and clinical significance of latent Brugada ECG pattern in young population (age ≤45 years) with lone AF. Methods A total of 78 patients with lone atrial fibrillation (mean age 35±7) were selected from 111 young patients with juvenile atrial fibrillation (age ≤45 years) between January 2015 and November 2017. All patients were clinically evaluated. Moreover 12 lead-24H Holter ECG and pharmacological class 1C antiarrhythmic drug (AAD) test were done for high suspicious cases of Brugada ECG. The diagnosis of Brugada ECG pattern was established according to the second consensus report criteria 2005 and since 2013, according to HRS/EHRA/APHRS expert consensus statement. Results According to the study protocol, we considered two groups of patients, group 1: 13 patients (16.7%; mean age 37±8) were diagnosed with type 1 Brugada ECG pattern (3 during class 1C AADs therapy and 10 induced by class 1C AAD test), group 2: 65 patients (83%; mean age 35±7) diagnosed as lone AF without type 1 Brugada ECG. The clinical characteristics of the two groups are described in table 1. Regarding to group 1, two patients had positive electrophysiological study with subsequent ICD implantation and genetic test for SCN5A mutation was positive in 3 patients. Table 1. G1, G2 clinical characteristics Patients characteristics Group 1 (n=13) Group 2 (n=65) P value Mean age (years) 37±8 35±7 0.42 Gender (Male %) 7 (54%) 54 (83%) 0.02 Family history of BrS 2 (15%) 0 (0%) 0.03 Family history of SCD 1 (8%) 1 (1.5%) 0.20 Syncope 4 (31%) 5 (8%) 0.02 Sick Sinus Syndrome 1 (8%) 7 (11%) 0.70 Paroxysmal AF 12 (92%) 54 (83%) 0.40 Suspected basal ECG for BrS 13 (100%) 28 (43%) <0.01 Statistical test is considered significant when p value <0.05. Conclusions Up to our knowledge this study is the first one that estimate the prevalence of latent BrS in juvenile lone AF patients. Young patients with lone AF had a high prevalence of latent BrS. Syncope, family history of SCD and family history of BrS are significant indicators of the presence of latent BrS in young patients with lone atrial fibrillation.

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P318 Left atrial dysfunction assessed by echocardiography in relation to left atrial fibrosis in patients undergoing ablation for atrial fibrillation

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jez319.171 ◽

2020 ◽

Vol 21 (Supplement_1) ◽

Author(s):

E Pilichowska ◽

J Baran ◽

P Kulakowski ◽

B Zaborska

Keyword(s):

Atrial Fibrillation ◽

Left Atrial ◽

Systolic Function ◽

Electrophysiological Study ◽

Stiffness Index ◽

P Value ◽

Group 2 ◽

Left Atrial Dysfunction ◽

Left Atrial Fibrosis ◽

Group 1

Abstract PURPOSE Left atrial (LA) fibrosis is the hallmark of LA remodeling in atrial fibrillation (AF), alters LA function and may predict poor catheter ablation (CA) outcome. LA fibrosis may be assessed invasively using electroanatomical mapping (EAM) during electrophysiological study. The aim was to assess LA function parameters in relation to degree of LA fibrosis derived from EAM in patients with AF. METHODS Patients (pts) n = 39 (79% males, mean age 56+/-10) with non-valvular AF were studied with TTE and TEE before first CA during sinus rhythm. LA strain (LAS) and strain rate (LASR) were analyzed in reservoir (r), conduit (cd) and contractile (ct) phases. The velocities of mitral A, E" and A" were measured with Doppler. E/E" and LA stiffness index - the ratio of E/E" to LASr were assessed. LA appendage flow velocity (LAAv) was measured in TEE. LA volume using biplane area-length method was calculated. The EAM of LA was build using Carto System before CA. Low amplitude potentials area (LAPA) was quantitatively analyzed and expressed as a percentage of LA surface using the cut-off <0.5 mV to detect sites of fibrosis. LA parameters were compared between mild (LAPA <10%) moderate (LAPA 10-40%) and extensive degree of LA fibrosis (LAPA >40%) (table). RESULTS The mean LA volume was 35 ± 11 mL/m². The LAPA ranged from 2 to 78 % of LA surface. Reduced LA function was observed in the LAPA >40% group. Extensive LAPA altered mainly LA compliance parameters. Traditional LA systolic function parameters did not differ in relation to degree of LAPA. CONCLUSION LA compliance is mostly affected by LA fibrosis, thus LA diastolic parameters may be useful in the noninvasive assessment of LA fibrosis. Whether these parameters should be a part of the proper selection of candidates for CA requires further studies. LA function parameters LA parameters Group 1 LAPA <10% n = 13 Group 2 LAPA >10% <40% n = 13 Group 3 LAPA >40% n = 13 P-value Group 1 + 2 vs 3 Mitral A 0.55 ± 0.10 0.55 ± 0.24 0.73 ± 0.32 0.077 A" 9.19 ± 1.74 7.85 ± 1.43 7.92 ± 2.40 0.376 LASr 31.48 ± 4.52 26.48 ± 8.79 19.63 ± 6.76 <0.001 LAScd 17.30 ± 3.05 15.44 ± 6.93 10.91 ± 4.04 0.003 LASct 14.18 ± 5.36 11.05 ± 3.67 8.72 ± 4.78 0.024 LASRr 1.22 ± 0.19 1.24 ± 0.21 0.92 ± 0.20 <0.001 LASRct -1.71 ± 0.46 -1.37 ± 0.34 -1.04 ± 0.33 <0.001 LA stiffness 0.20 ± 0.07 0.34 ± 0.17 0.63 ± 0.29 <0.001 LAAv 0.83 ± 0.18 0.55 ± 0.17 0.60 ± 0.16 0.178

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Clinical significance of family history and bicuspid aortic valve in children and young adult patients with Marfan syndrome

Cardiology in the Young ◽

10.1017/s1047951120000748 ◽

2020 ◽

Vol 30 (5) ◽

pp. 663-667 ◽

Cited By ~ 1

Author(s):

Emanuele Monda ◽

Adelaide Fusco ◽

Daniela Melis ◽

Martina Caiazza ◽

Felice Gragnano ◽

...

Keyword(s):

Young Adult ◽

Family History ◽

Aortic Valve ◽

Marfan Syndrome ◽

Bicuspid Aortic Valve ◽

Young Patients ◽

P Value ◽

Z Score ◽

Aortic Sinus ◽

History Of

AbstractBackground:Marfan syndrome is an autosomal dominant disorder of the connective tissue, whose cardinal features affect eyes, musculoskeletal, and cardiovascular system. Despite prevalence and natural history of cardiovascular manifestation are well known in adults, little is known about children and young adult patients. The aim of this study was to describe a well-characterised cohort of consecutive children and young patients with marfan syndrome, looking at the impact of family history and presence of bicuspid aortic valve on disease severity.Methods:A total of 30 consecutive children and young patients with Marfan syndrome were evaluated. All patients underwent a comprehensive clinical–instrumental–genetic evaluation. Particular attention was posed to identify differences in prevalence of cardiovascular abnormalities between patients with and without family history of Marfan syndrome or bicuspid aortic valve.Results:Of these 30 patients, family history of Marfan syndrome and bicuspid aortic valve were present in 76 and 13%, respectively. Compared to patients with family history of Marfan syndrome, those without showed higher prevalence of aortic sinus dilation (87 versus 32%, p-value = 0.009), greater aortic sinus diameters (4.2 ± 2.1 versus 1.9 ± 1.1 z score, p-value = 0.002), and higher rate of aortic surgery during follow-up (37 versus 0%, p-value = 0.002). Compared to patients with tricuspid aortic valve, those with bicuspid aortic valve were younger (3.2 ± 4.3 versus 10.7 ± 6.8 years old, p-value = 0.043), showed greater aortic sinus diameters (4.2 ± 0.9 versus 2.2 ± 1.6 z score, p-value = 0.033), and underwent more frequently aortic root replacement (50 versus 4%, p-value = 0.004).Conclusions:In our cohort of patients with Marfan syndrome, the absence of family history and the presence of bicuspid aortic valve were associated to severe aortic phenotype and worse prognosis.

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Comparison of Rosuvastatin versus Atorvastatin for Preventing Postoperative Atrial Fibrillation

The Heart Surgery Forum ◽

10.1532/hsf98.20121061 ◽

2013 ◽

Vol 16 (3) ◽

pp. 158 ◽

Cited By ~ 5

Author(s):

Okay Abaci ◽

Cuneyt Kocas ◽

Veysel Oktay ◽

Cenk Eray Yildiz ◽

Kadriye Orta Kilickesmez ◽

...

Keyword(s):

Atrial Fibrillation ◽

Cardiac Surgery ◽

Left Ventricular ◽

Postoperative Atrial Fibrillation ◽

Atorvastatin Treatment ◽

Elective Cardiac Surgery ◽

Increased Risk ◽

History Of ◽

Group 2 ◽

Group 1

Background: Postoperative atrial fibrillation (AF) following cardiac surgery is associated with an increased risk of stroke, prolonged hospitalization, and increased costs. Statin therapy is associated with a lower incidence of postoperative AF. We aimed to compare the preventive effects of rosuvastatin and atorvastatin on postoperative AF.Methods: This study included 168 patients undergoing elective cardiac surgery with cardiopulmonary bypass. Patients were divided into 2 groups according to treatment of statin. Group 1 (n = 96) was patients receiving atorvastatin, and group 2 (n = 72) was patients receiving rosuvastatin. Postoperative electrocardiographs (ECGs) and telemetry strips were examined for AF within postoperative period during hospitalization.Results: The incidences of postoperative AF were 17.9% (n = 17) in group 1 and 22.2% (n = 16) in group 2 (P = .48). Left ventricular end-diastolic diameter (LVEDD) and ejection fraction (EF) were not different between groups. Incidence of diabetes, hypertension, hyperlipidemia, smoking, myocardial infarction in past medical history, family history of atherosclerosis, male sex, drug use, and perioperative features were similar between groups.Conclusions: The present study revealed that preoperative rosuvastatin or atorvastatin treatment did not have a different effect in preventing postoperative AF.

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Prevalence and spectrum of MLH1, MSH2, and MSH6 pathogenic germline variants in Pakistani colorectal cancer patients

Hereditary Cancer in Clinical Practice ◽

10.1186/s13053-019-0128-2 ◽

2019 ◽

Vol 17 (1) ◽

Cited By ~ 1

Author(s):

Muhammad Usman Rashid ◽

Humaira Naeemi ◽

Noor Muhammad ◽

Asif Loya ◽

Jan Lubiński ◽

...

Keyword(s):

Colorectal Cancer ◽

Family History ◽

Lynch Syndrome ◽

Research Centre ◽

Germline Variants ◽

Pathogenic Variants ◽

History Of ◽

Group 2 ◽

Colorectal Cancer Patients ◽

Group 1

Abstract Background Pathogenic germline variants in MLH1, MSH2 and MSH6 genes account for the majority of Lynch syndrome (LS). In this first report from Pakistan, we investigated the prevalence of pathogenic MLH1/MSH2/MSH6 variants in colorectal cancer (CRC) patients. Methods Consecutive cases (n = 212) were recruited at the Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC), between November 2007 to March 2011. Patients with a family history of > 3 or 2 HNPCC-associated cancers were classified as HNPCC (n = 9) or suspected-HNPCC (n = 20), respectively (group 1; n = 29). Cases with no family history were designated as non-HNPCC (group 2; n = 183). MLH1/MSH2/MSH6 genes were comprehensively screened in group 1. Pathogenic/likely pathogenic variants identified in group 1 were subsequently evaluated in group 2. Results Eight distinct pathogenic/likely pathogenic MLH1/MSH2 variants were found in group 1 (10/29; 34.5%), belonging to HNPCC (5/9; 55.6%) and suspected-HNPCC (5/20; 25%) families and in group 2 (2/183; 1.1%) belonging to non-HNPCC. Overall, three recurrent variants (MSH2 c.943-1G > C, MLH1 c.1358dup and c.2041G > A) accounted for 58.3% (7/12) of all families harboring pathogenic/likely pathogenic MLH1/MSH2 variants. Pathogenic MSH6 variants were not detected. Conclusion Pathogenic/likely pathogenic MLH1/MSH2 variants account for a substantial proportion of CRC patients with HNPCC/suspected-HNPCC in Pakistan. Our findings suggest that HNPCC/suspected-HNPCC families should be tested for these recurrent variants prior to comprehensive gene screening in this population.

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Clinical Characteristic of Young Indonesian Colorectal Cancer Patients: A Preliminary Study

Medicinus ◽

10.19166/med.v5i3.1171 ◽

2018 ◽

Vol 5 (3) ◽

Author(s):

Nata Pratama Lugito

Keyword(s):

Colorectal Cancer ◽

Family History ◽

Young Patient ◽

General Hospital ◽

Clinical Characteristics ◽

Young Patients ◽

Old Patients ◽

Family History Of Cancer ◽

History Of ◽

History Of Cancer

Introduction: Colorectal cancer (CRC) is generally a disease of persons aged above 40 year-old. Controversies still exist regarding clinical characteristics of CRC in young persons. The aim of this study is to know the clinical characteristics of young CRC patients in Siloam General Hospital, Karawaci, Banten.Material And Methods: A total of 14 patients with diagnosis of CRC from December 2013 to January 2014 in Siloam General Hospital, Karawaci, Banten were studied cross – sectionally. The symptoms and signs, family history of cancer, diabetes, location of mass were collected and evaluated.Results: There were 5 (35.7%) cases of CRC patients aged below 40 year-old (young patients) and 9 (64.3%) above 40 years-old (old patients). The most common symptom was constipation followed by bloody diarrhea i.e. 57.1% and 42.9% consecutively. Constipation occurred in 2 and 6 young and old patients consecutively and in 3 and 3 young and old patients consecutively. In young patients, 2 (14.2%) had a history of cancer in the family compared to none in the old patients. According to the location of tumor in the colon 4 (28.5%) were in ascending colon with 2 and 2 in young and old patients consecutively, 3 (21.7%) were in descending colon with 2 and 1 in young and old patients consecutively, 8 (57.1%) were in rectum with 2 and 6 in young and old patients consecutively. One young patient had diabetes, and one other young patient had positive Clostridium difficile antigen and toxin.Conclusion: Approximately 35.7% cases CRC patient in our hospital was of young patients. Two patients were having family history of cancer. The location of mass was not specific for young CRC patients.Key words: colorectal cancer, young patients

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Clinical Safety and Efficacy of Ablation for Atrial Fibrillation Patients With a History of Stroke

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.630090 ◽

2021 ◽

Vol 8 ◽

Author(s):

Zi-liang Song ◽

Shao-hui Wu ◽

Dao-liang Zhang ◽

Wei-feng Jiang ◽

Mu Qin ◽

...

Keyword(s):

Atrial Fibrillation ◽

Clinical Safety ◽

Safety And Efficacy ◽

Linear Lesions ◽

Significant Difference ◽

Stroke Group ◽

History Of ◽

Group 3 ◽

Group 2 ◽

Group 1

Objectives: To evaluate the clinical safety and efficacy of radiofrequency catheter ablation for atrial fibrillation patients with a history of stroke.Methods and Results: A total of 116 symptomatic, drug-refractory AF patients with a history of stroke, and 1:2 matched patients without a history of stroke were enrolled. Of these, 28 cases occurred stroke within 3 months (Group 1), 88 cases with stroke history longer than 3 months (Group 2), and 232 cases without stroke (Group 3). PVI was performed in all patients, extended to ablation of linear lesions ablation. The periprocedural stroke rates and other procedure-related in-hospital complications did not differ significantly among the three groups. The maintenance rate of SR after the procedure showed no significant difference (p = 0.333), 52.7, 66.4, and 70.7% in Group 1, 2, and 3, respectively. Furthermore, the comparison between a history of stroke and those without it were also shown no significant difference (p = 0.351).Conclusions: Radiofrequency ablation for AF patients occurred stroke, even within 3 months is safe and effective, without higher periprocedural complication rate and recurrence rate.

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Clinical Evaluation of Glass-Lonomer Cement and Giomer for the Management of Cervical Caries

Chattagram Maa-O-Shishu Hospital Medical College Journal ◽

10.3329/cmoshmcj.v20i2.56476 ◽

2021 ◽

Vol 20 (2) ◽

pp. 60-64

Author(s):

Nurun Nahar ◽

Tareq Hassan ◽

Mohammed Kamal Uddin

Keyword(s):

Patient Group ◽

Glass Ionomer Cement ◽

P Value ◽

Filling Material ◽

Glass Ionomer ◽

Secondary Caries ◽

History Of ◽

Group 2 ◽

Ionomer Cement ◽

Group 1

Background: Giomer is a unique class of restorative material has been introduced as the true hybridization of Glass Ionomer (GI) and composite resin and has the distinguishing feature of a stable surface pre-reacted glass ionomer. Glass Ionomer Cements (GIC) are also unique restorative materials with many uses in clinical practice and provide for caries-protective fluoride releasing at the margins of restorations, as well as their ability to have the fluoride within their chemical matrix recharged by outside exposure to other fluoride-containing materials. The present study aim at clinically evaluate the comparison between the glass Ionomer cement and Giomer for the management of cervical caries. Materials and methods: The study was a cross sectional comparative study which was carried out from 01 December 2018 to 31 November 2019 in the Department of Conservative Dentistry and Endodontics, Bangladesh Dental College, Dhanmondi, Dhaka. Total number of cases was 80. The patients were divided into two groups, half of the patient (Group-1) was treated with Glass Ionomer cement and half of the patient (Group-2) was treated with Giomer restoration. The post-operative sensitivity discoloration, dislodgement of filling material and secondary caries formation were recorded. All the patients were assigned and the data were analyzed statistically by SPSS version 21. p-value < 0.05 was taken as significant. Results: The study reveals 60% of the study population was within 41 to 50 years of age group (Group-1) and 62.5% were 51 to 60 years (Group-2) 45% in (Group-1) and 10% in (Group-2) had history of post filling sensitivity, 12% in (Group-1) and 5% in (Group-2) had discoloration after restoration, 2.5% had history of dislodgement of the filling in (Group-1), no history of dislodgement of the filling in (Group-2), 2.5% had history of secondary caries formation in (Group-1) and no history of Secondary caries formation in (Group-2). Conclusion: Patients were more approachable for Giomer restoration than Glass ionomer for the management of cervical caries over a period of 12 month. Chatt Maa Shi Hosp Med Coll J; Vol.20 (2); July 2021; Page 60-64

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Relationship of Allergy, Enuresis, and Urinary Infection in Children 4 to 7 Years of Age

PEDIATRICS ◽

10.1542/peds.57.4.526 ◽

1976 ◽

Vol 57 (4) ◽

pp. 526-528

Author(s):

Sharon Siegel ◽

Leslie Rawitt ◽

Burton Sokoloff ◽

Bernard Siegel

Keyword(s):

Family History ◽

Statistical Difference ◽

Urinary Infection ◽

Respiratory Allergy ◽

Control Group ◽

History Of ◽

Group 2 ◽

And Control ◽

Day Wetting ◽

Group 1

A group of 234 children, 4 to 7 years old, in a middle- to upper-middle-class Caucasian population, were divided into four groups and matched for age and sex. Group 1 consisted of 50 children previously treated for urinary infection; control group 1 contained 55 well children; group 2 consisted of 69 children treated for respiratory allergy; and control group 2 contained 60 well children. There was no statistical difference in persistent enuresis (night wetting every week), persistent day wetting (every week), allergy, or family history of enuresis, when group 1 and control group 1 were compared. A family history of urinary infection was higher (P < .05) in group 1. There was no statistical difference in persistent enuresis, persistent day wetting, previous urinary infection, or family history of enuresis or urinary infection when group 2 and control group 2 were compared. This study suggests that there is no relationship between respiratory allergy, enuresis, and urinary infection.

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The clinical course of atrial fibrillation in patients with coronary heart disease

Clinical Medicine (Russian Journal) ◽

10.18821/0023-2149-2016-94-8-591-595 ◽

2016 ◽

Vol 94 (8) ◽

pp. 591-595 ◽

Cited By ~ 1

Author(s):

V. I. Podzolkov ◽

Aida I. Tarzimanova ◽

R. G. Gataulin

Keyword(s):

Myocardial Infarction ◽

Heart Failure ◽

Atrial Fibrillation ◽

Coronary Heart Disease ◽

Heart Disease ◽

Chronic Heart Failure ◽

Clinical Course ◽

History Of ◽

Group 2 ◽

Group 1

The modern medical literature practically does not contain clinical publications reporting studies of factors responsible for progression of atrial fibrillation (AF) in patients with coronary heart disease (CHD). It accounts for the importance of investigations into evolution of the clinical course of AF in such patients.Aim. To elucidate evolution of the clinical course of AF in patients with CHD in a long-term prospective study.Materials and methods. The study included. 112 patient aged 57-74 (mean 67.44±3.3) years with CHD and paroxysmal form of AF carried outfrom 2011 to 2015. Evolution of the clinical course of AF was evaluated based on the number of arrhythmic attacks during the last 3 months. The appearance ofprolonged persistent AF episodes or permanent AF was regarded as progression of arrhythmia.Results. During the 4 year study, 64 (57,2%) patients (group 1) did not experiencea rise in the frequency and duration of AF attacks. Progression of arrhythmia was documented in 48 (42,8%) of the 112 (100%) patients (group 2). These patients more frequently had the history of myocardial infarction and chronic heart failure than patients of group 1. The latter had the mean values of left ventricular (LV) ejection fraction 61,23±6,24%, i.e. significantly higher than 48,47±8,4% in group 2.47 and 28 % of the patients in group 2and 1 respectively suffered mitral regurgitation (p<0,05). Patients of group 2 had significantly more akineticzones. Intake of nitroglycerin in group 1 resulted in positive dynamics of local LV contractility that did not change in patients of group 2. Conclusion. 42,8% of the patients with CHD and paroxysmal form of AF experienced progression of arrhythmia into a persistent or permanent form. Predictors of AF progression in patients with CHD are the history of myocardial infarction, chronic heart failure, mitral regurgitation, and irreversible changes in local myocardial LV contraction.

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Specificities of small airways dysfunction development in patients with mild asthma

Russian Open Medical Journal ◽

10.15275/rusomj.2021.0105 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Elena E. Mineeva ◽

Marina V. Antonyuk ◽

Alla V. Yurenko ◽

Tatyana A. Gvozdenko ◽

Oksana Yu. Kytikova

Keyword(s):

Family History ◽

Allergic Diseases ◽

Mild Asthma ◽

Control Group ◽

Bronchial Obstruction ◽

Small Airways ◽

Asthma Patients ◽

History Of ◽

Group 2 ◽

Group 1

The study goal was to identify specificities of small airways dysfunction development (SAD) in patients with mild asthma. Material and Methods — The study involved 114 patients with mild asthma. Depending on the condition of their small airways, the patients were split among two groups: Group 1 of 94 patients with asthma without SAD (82.5%); Group 2 of 20 patients with asthma and SAD (17.5%). The control group consisted of 25 volunteers. SAD was diagnosed by the presence of air trapping and hyperinflation. Results — SAD was diagnosed in 17.5% of patients with mild asthma. The development of SAD was observed in 80% of asthma patients with ailment duration of over 5 years and family history of asthma. Obesity was diagnosed 1.7 times more often in patients with SAD compared with those without it. Food allergy, allergic rhinitis, allergic conjunctivitis, urticaria and bronchial obstruction were identified two or more times more often in patients with SAD compared with those without it. Among all patients with mild asthma and SAD, bronchial obstruction was detected in 55% of cases. Conclusion — The development of SAD in the presence of mild asthma is characteristic for patients with ailment duration over 5 years, family history of asthma, obesity, predominant sensitization to food allergens, and concomitant non-pulmonary allergic diseases. Bronchial obstruction is not the obligatory feature of SAD development in presence of mild asthma.

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